To reduce infant mortality in the District through cooperative perinatal studies and interventions in minority populations, the District of Columbia General Hospital (DCGH) proposes to provide clinical, outreach, and laboratory resources and community access to target populations based on its charter to provide comprehensive services to residents of the District without regard to their ability to pay. Critical resources include OB/GYN, Pediatrics (NICU Level III and Boarder Baby Nurseries), Maternal and Child Health Nursing, Psychiatry, Substance Abuse Program, Social Services, HIV Center, Maternal and Child Nutrition/WIC, Emergency Services, Laboratory Medicine, Pharmacy, and Emergency Psychiatric Response Division/St. Elizabeths Hospital, on campus services such as the DHS Treatment Center (Women's Service, STD Clinic, TB and Chest Clinic) , Karrick Hall (residential drug treatment for pregnant and postpartum women), DC Medical Examiner, DC Jail, and the DC Commission on Public Health, office of Maternal and Child Health, Family and Child Services, Public School System, Neighborhood DHS Clinics, and Office of Emergency Shelters. As a clinical, research, and training hospital, DCGH is affiliated with universities such as Georgetown, Howard, Maryland, Johns Hopkins, Pennsylvania, UCLA, GW, and St. Elizabeths Hospital. The volunteer pool draws from over 100 organizations. Research and demonstration projects demonstrating DCGH experience and expertise include outreach and care for pregnant substance abusing women, homeless women and children in shelters, incarcerated women, HIV positive infants, children, and families, Healthy Start , and research targeted on maternal lifestyle and infant development. In 1991 the prenatal clinic had 8232 patient visits, the prenatal clinic for substance abusers 1040; only 60% received more than 4 of the 14 recommended visits; and 60% had public or private insurance. Of 2,099 live births at DCGH in 1991, 17.6% were low birth weight (less than 2500 gm). LBW and maternal substance abuse were the leading causes of infant mortality (rate of 9.5) in the African American and Hispanic population served by DCGH (70% and 24%).